By Marsha N. Woolery (Part 1 was published October 24)
Cancer treatment has several side effects that may affect health and nutritional status. These side effects are often the reasons that many persons with breast cancer choose not to receive treatment. The side effects of treatment include loss of appetite, early satiety, loss of muscle, oedema, nausea, pain, loneliness, and emotional changes.
The loss of appetite may sometimes be as a result of one's state of mind, the disease itself, and medication. The loss of appetite may be treated by consuming small, frequent meals that are nutrient dense and using appetite-enhancing medications as prescribed by a registered medical practitioner.
Early satiety is feeling full shortly after starting to eat a meal. Foods that are nutrient dense should be consumed, such as thick porridges with extra skimmed milk and margarine, one-pot meals such as soup with meat, grated or cubes of cheese, seasoned rice with vegetables and chicken, shakes made with oats, milk and fruits or vegetables.
Small, frequent meals
Small, frequent meals with snacks in-between meals are also recommended. Milk powder, cheese and margarine may be added to food items for extra protein and energy. Fatty foods should be avoided because they take a long time to be digested and absorbed. Muscle wasting or loss of lean body mass may be as a result of tumour growth. Protein intake should be increased along with exercise - especially endurance activities such as walking to improve upper- and lower-body strength and self-image.
Oedema, or excess fluid in cells, which is sometimes interpreted as weight gain, is treated by limiting salt or sodium containing foods in the diet. Nausea may be caused by the medication or cancer treatment and the smell of food. Small meals made up of dry foods such as baked chicken, toast and crackers should be consumed frequently. Liquids should be had between meals in order not to cause nausea. After eating, one should remain seated in an upright position. Meals should not be skipped, and it is recommended that persons receiving treatment drink plenty of water the day before and after chemotherapy.
Pain can cause persons to eat less. Therefore, it is recommended that meals and snacks be consumed when pain is at its lowest, and nutrient-dense foods should be offered. The feeling of loneliness or emotional changes can be alleviated by encouraging eating in the company of others. Foods eaten should be liked, and the foods eaten in company should be the same as others so that the person won't feel different at mealtimes.
All the above conditions may lead to malnutrition if not treated or managed properly, which in turn may result in premature suffering and death. Persons with breast cancer can improve their quality of life and wellness profile with proper nutrition. Small, frequent, well-balanced, nutrient-dense meals and snacks that are low in animal fat, red meat and refined foods and high in fruits, vegetables, unrefined carbohydrate-rich foods, peas, beans, nuts and low-fat animal foods should be consumed in a comfortable, relaxing environment. The texture and taste of food should be changed to benefit the person being treated with breast cancer.
Marsha N. Woolery is a registered dietitian/nutritionist in private practice and adjunct lecturer at Northern Caribbean University; email: firstname.lastname@example.org.